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A court system with some teeth to it

Wednesday, May 09, 2007
Chicago Tribune
by Ray Quintanilla, Tribune staff reporter

The dentist peers into little Guillermo Garcia's mouth and makes an unpleasant discovery: a dozen cavities, and the boy is only 7 years old. It's a similar story for another child who squirms on his mother's lap while waiting his turn in the dentist's chair.

But this isn't a typical dental office. Tucked away in an obscure second-floor wing of the Rolling Meadows courthouse, it's a place where thousands of people who need their teeth drilled take a seat a short distance from those who grit their teeth in a criminal courtroom.

Despite the contrasting backgrounds of those arriving at the courthouse, the dental clinic's unusual location has proven to be a successful model for delivering care to needy patients, experts say.

It's been so successful, in fact, it's rarely publicized out of fear that more patients would flood a system that narrowly escaped closing during the last round of Cook County budget cuts.

"What's important is the poor get dental care, not so much where they have to go to get it," said Dr. Virginia Dominguez, who supervises the clinic and examined Garcia's mouth.

"This is care to treat pressing problems, and it's for people who have no other place to go," she said. "This is for fillings, treating problems with pain and for extractions."

The Cook County Department of Public Health has housed dental clinics in the Rolling Meadows and Bridgeview courthouses for two decades because the locations were convenient and cheap. Combined, they handle about 3,400 patients annually.

The county's two other clinics are in office buildings in South Holland and Maywood and handle about 2,900 patients a year, officials said.

"These clinics fill a very important void to a segment of the population that's in need," said Dr. Stephen Martin, Cook County's public health chief, who fought to keep the clinics open. "A great deal of wonderful work is taking place there."

No one is sure why the courthouse clinics have proven so effective, since very few who get care there have any ties to the criminal justice system, county officials said. Some patients say they learned about the clinic after being married in the courthouse.

Others say it's just a convenient stop, not far from other programs that help single mothers.

What's certain, said Dr. Indru Punwani, a professor at the University of Illinois at Chicago and director of its pediatric dental department, is that these dental clinics are becoming more essential in the face of shrinking workplace dental coverage and the growing cost of dental care.

"A large segment of those needing care tend to be children," said Punwani, a dentist. "Programs like Cook County's are a safety net for lots of people, including those in between jobs and the elderly."

Punwani said it's difficult to quantify the need for dental services. But he said long lines of patients wait at Stroger Hospital's emergency room every day seeking extractions and treatment for gum disease and infections -- more costly procedures than prevention.

The push now, county officials say, is to persuade patients to have sealants put on their teeth to thwart cavities.

At the Rolling Meadows clinic, Guillermo's mother, Nohemi Vela, said she took him there because her meat-processing job doesn't provide dental coverage or any other insurance.

"He's been complaining about his teeth for a few days, and I just don't have the money to pay a doctor," said Vela, 48, who earns minimum wage.

"Thank God, a friend referred me here. I didn't know what to do with my son crying so much."

Guillermo admitted that he hasn't always brushed regularly. After getting his teeth drilled, he could hardly speak without his eyes welling up.

"I just want the pain to go away," he said, clutching his mother's leg in the waiting room. "Mommy, I want to go home."

Redivel Pardo, a dental assistant in the Rolling Meadows office, said the waiting room often is packed with young families. It's not unusual to work through the lunch hour, she said.

But doing a good job means they can see only about 12 patients per day. "You want to be thorough and give everyone the right attention," she said.

Juana Hernandez, who works in a northwest suburban plating factory, has taken her three children to the Rolling Meadows clinic for five years. At first she took them because they were complaining about pain.

Lately, she has visited every few weeks so the dentist can finish filling a half-dozen cavities for her daughter Lorena, 8.

"I tell the kids all the time to brush their teeth," said Hernandez, 34 "I watch them, but sometimes the kids don't listen and they go straight to bed without brushing."

Lorena said there is no pain quite like a toothache. It can be so intense, it makes sleeping nearly impossible, she said.

"I am taking care of my teeth from now on," said Lorena, an elementary school pupil from Mt. Prospect. "I don't want to be in pain anymore."

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